Blue Ridge Medical Management Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Practice address

410 N State of Franklin Rd Ste 135B
Johnson City, TN 37604-6972

Phone

(423) 431-2350

Fax

(423) 431-2372

NPI assigned

Oct 22, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carl Kilgore

Title

President

Phone

(423) 302-3051

Specialties & licenses 2

Addresses

Other names 3

• Ballad Health Medical Associates Doing business as
• MSMG Neurology OPJohnson City Doing business as
• BHMA Neurology OP Johnson City Other name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan Dale Carter, PA

  • Physician Assistant
  • Kingsport, TN
  • NPI 1295273480
  NPD
• Benjamin Eric Jewett, MD

  • Neurology Physician
  • Johnson City, TN
  • NPI 1184283889

  Neurology

  NPD
• Isaac Nathan O'Dell, PA

  • Surgical Physician Assistant
  • Johnson City, TN
  • NPI 1821035908
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1922574474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD STE 135B",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046972",
            "telephone_number": "423-431-2350",
            "fax_number": "423-431-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD STE 135B",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046972",
            "telephone_number": "423-431-2350",
            "fax_number": "423-431-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-22",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-302-3051"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMG Neurology OPJohnson City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHMA Neurology OP Johnson City",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Management Corporation
• Blue Ridge Medical Mangement Corporation

• All providers in Johnson City, TN
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.